W008 – Additional subsequent visits
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
An intermediate assessment is a primary care service for a patient in a long-term care institution (chronic care hospital, convalescent hospital, nursing home, home for the aged, or designated chronic/convalescent care bed). It is a subsequent visit following the patient's admission to the institution and requires a history of the presenting complaint(s), inquiry concerning, and examination of the affected part(s), region(s), system(s), or mental or emotional disorder as needed to make a diagnosis, exclude disease, and/or assess function. Note: This service is a component of the Monthly Management of a Nursing Home or Home for the Aged Patient (W010) and is not separately payable if W010 is claimed for the same calendar month by the most responsible physician (MRP). See - for details.
When to Use
- Use W008 for routine subsequent assessments of a patient in a long-term care facility when you are not the Most Responsible Physician (MRP) claiming the W010 monthly management fee.
- Use W008 when you are the MRP but have already reached the maximum allowed monthly management fee or are providing visits beyond the scope of the W010 monthly management requirement.
- Use W008 for follow-up assessments of your own patients in a chronic care or convalescent hospital setting where W010 does not apply.
Common Pitfalls
- Billing W008 on the same claim as W010 will result in an automatic rejection, as W008 is considered bundled into the monthly management fee.
- Attempting to use W008 for an acute intercurrent illness; these should be billed under W121 to ensure appropriate tracking and payment.
- Billing W008 for patients in acute care settings; this code is strictly reserved for long-term care, chronic care, or convalescent facilities.
Billing Tips
- If you are the MRP, track your W008 visits throughout the month to ensure you meet the minimum requirements for the W010 monthly management fee claim.
- When assessing another physician's patient in the same facility on an emergency basis, use 'A' prefix codes instead of W008 to ensure the service is paid as a separate assessment.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
Appropriate medical records must be kept to establish that an insured service was provided, the service claimed is the service rendered, and the service was medically necessary, as per .
As an assessment, this service includes the specific elements outlined in , including a direct physical encounter, history taking, physical examination, and appropriate documentation of these components in the medical record.
Submit claims for acute intercurrent illnesses requiring visits other than special visits using W121. When acute intercurrent illness requires a special visit, submit claims using the appropriate fees under General Listings ('A' prefix) and premiums.
When a physician is already in the institution and is asked to assess one of his/her own in-patients, the subsequent visit listings ('W' prefix) apply. However, if he/she is already in the institution and asked to assess another physician's patient on an emergency basis, submit claims using the General Listings ('A' prefix).
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